Adding a million years to the lives of East Lancashire's population requires a big push by local partnerships, says David Peat

Every now and again, things come together well to produce a lot of energy. It is the trick of good management to make this happen. But, if truth be told, every chief executive needs a helping hand to take advantage of the coming together of circumstances.

East Lancashire primary care trust's project on health inequalities is a case in point. We all know that something must be done to end the iniquitous differences in life expectancy, infant mortality, the abuse of alcohol and use of drugs, and the high death rate from chronic heart disease. Parts of my patch in East Lancashire have some of the worst indices possible as part of the legacy of poor expectations, poor health and inadequate housing, diet and levels of education.

Significant progress has been made over the years but the gaps between different wards in the same town, between different boroughs, and between our area as a whole and the rest of England, is widening.

What we needed was an injection of passion and commitment. That has come in large measure from our chair and non-executive directors, who steered a willing board into a targeted course of action, with defined and specific targets that are not only measurable, but also quite ambitious.

Through our chair, we invited a local junior school headteacher to address the board about her take on the issue of health inequalities. What she told us was horrendous and very personal and it galvanised an already keen and professional set of executives into overdrive.

Our other incentive was that our strategic health authority was thinking along the very same lines, with a clear set of targets to break the North West's deprivation once and for all. Then, when health secretary Alan Johnson made health inequalities his number one target in his first major speech, we knew we were in tune with the new composition already being written.

Knowing we cannot end deprivation in one swoop or on our own, we have already corralled all the local stakeholders behind the initiative, set ambitious targets, committed an extra£2m to increase resources and fire power, given our managers and public health teams the go-ahead to make it happen and put the communications back-up in place to get the messages across, both internally and externally. We even have the blessing of NHS chief executive David Nicholson, who was the main speaker at our October Health Summit, which was designed to sign up all the necessary partners.

Our top-line target is to gain collectively a million years of extra life for our population within the next four years. Ambitious? Maybe, but we are committed and determined all the same. Our three target areas are:

  • tackling coronary heart disease;

  • reducing infant mortality rates;

  • preventing alcohol and drug abuse.

The fourth dimension is not conceptual but geographical, in that we will target specifically our 20 most deprived wards.

The job for my executives is to keep the project on course, with evidence-based initiatives and increased staffing in the targeted areas, while maintaining a clear sense of direction and a clear sense of purpose for us and our partners.

We are embracing social marketing for our campaign because it can potentially help us understand the people affected and the task in hand. It can also help to unlock the positive energy of local people who live in the targeted communities.

Most people only react to personal trauma or shock therapy to make them change the habits of a lifetime, whether that be the advent of a heart attack, a loved-one leaving them or waking up drunk in a police cell. That is the harsh reality.

Our public health director Dr Ellis Freidman is spot on when he says: 'Our task is to get people to act without the mechanism of that kind of shock. But the shocking facts and figures often are not enough.'

Whatever we come up with in the unfolding months ahead, our chair Kathy Reade is adamant that we should make a difference.

As she says: 'When our children face dying before their parents, we have to act.' With good planning, good management and good luck, let's hope we get there.